Monthly Chat is an interview that runs on the Times Opinion pages. Look for this space each month to see conversations between Publisher Denise Dunbar and Alexandrians from all walks of life. This month’s conversation is with Christine Candio, CEO of Inova Alexandria Hospital.

By Denise Dunbar

You run the single largest nongovernmental organization in Alexandria, with 1,845 employees, have lived in Alexandria for five years and have made impressive improvements to the hospital. What else can you tell us about yourself?

CC: I’ve been in the health-care field for 30 years and am a registered nurse by training. I have a wide variety of clinical experience, worked in women’s services for a number of years and ran a large hospital-based ambulatory service comprised of 33 different clinics. I’m originally from New Jersey but was recruited to the Boston area and spent nine years there as executive vice president of the Hallmark Health System. I’ve just been named chairman-elect of the American College of Healthcare Executives, which has 43,000 members. This is a three-year term that begins in March.

What is the most significant accomplishment at the hospital during your tenure as CEO?

CC: We just completed in 2012 a major $84 million capital improvement project (the planning for this started in ’05 or ’06 before I came on board). We tried to figure out what the demographics would look like in the future and what the needs of the community would be, including which services would be needed by an aging population. We did a total renovation and update of our cardiovascular unit. We also built a new post-surgical program and enhanced our joint replacement program.
The volume of our emergency department has increased every year I have been here to 67,000 patients seen in 2012. A big part of this project was an emergency expansion.

There is actually another accomplishment I would rank with the capital improvement project and that was the ribbon- cutting we had in December for the Joseph Viar Jr. and Bonnie Christ Cancer Center. This center offers a full spectrum of cancer care, including surgery, radiation therapy and chemotherapy — and the state of the art nano knife. With the nano knife we are able to provide treatment to people who were considered inoperable — an opportunity to give treatment to people who otherwise wouldn’t have options. Nano knife can remove tumors that are very small or in difficult to get to areas. We are the first hospital in the D.C. area to have this treatment. Patients from all over the country and even international patients are inquiring about nano knife. It’s amazing to think that we are able to provide this treatment right in our community to our community members.

How did you raise the money for the capital improvement project?

CC: The level of support we received from the community was outstanding. Our own foundation board worked tirelessly and raised $25 million, and the rest came from bonds. Alexandria is a very philanthropic city.

What impact will the Affordable Care Act have on Inova Alexandria hospital?

CC: I’m pleased that through [ACA] more people will have insurance. Other elements, like people with pre-existing conditions not being denied care, are so important. The reality is health-care spending as it is today is not sustainable. We are doing our part at this hospital to improve the value proposition to our patients. We’re trying to improve patient quality, experience and affordability. The affordability piece is crucial for the future.

How are you going about making care more affordable?

CC: We have looked carefully at ways to remove waste from within our system. One perfect example is the work we’ve done with emergency department patient flow. We examined how to reduce the time the patient spends from when they come in until when they leave. Before tackling this issue, the average time spent in our emergency room was 220 minutes. We got everyone involved together and considered all of the steps patients go through. We made major changes, decreasing the number of steps and made our emergency care more effective for patients. Now our average time spent in the emergency room is down to between 130 and 140 minutes. We post real time emergency room wait times on the Internet — we even have an app for it. There are always exceptions to this, like now when hospitals are full because we’re dealing with a severe flu outbreak.

How do you cope when there’s an unusually bad flu season like this year?

CC: We’ve had to work hard to manage the flu. Doctors screen patients who come in and test for flu. There are certain rooms for isolation — patients with flu are put in those. We use protective equipment and universal precautions. In addition, prior to that, we worked with the staff and everyone received the flu vaccine. We also put in restricted visiting hours. This year’s bad flu outbreak across the country was somewhat unexpected.

What final thing would you like our readers to know about Inova Alexandria Hospital?

CC: I’m very proud of the most-recent U.S. News and World Report ranking of our hospital, based on quality outcomes. We were ranked fourth out of 59 hospitals in the [region] and were the top-ranked community (nontrauma center) hospital. We were also ranked fifth in the commonwealth of Virginia.